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Falls are a significant threat to the functional status and quality of life of people with intellectual disabilities (ID), with consequences similar to those experienced by older persons. However, knowledge and evidence for appropriate interventions are limited. Research has shown that people with ID have delayed balance and gait capacities, which are limiting factors for mobility and fall risk. A physical activity-based intervention targeting balance and gait, as well as other domains, is necessary to address the multifactorial nature of falls in people with ID.

The ProAct65+ Exercise Trial is a multi-centre cluster randomised controlled trial comparing two exercise interventions, the Otago home-based exercise programme (OEP) and the Falls Management Exercise (FaME) programme, with a control group, in patients aged 65 and over in primary care. The trial has recruited 1256 participants and aims to provide an overview of the trial, its practical implications, and lessons learned.

Recording adverse events in complex interventions such as exercise in older people is crucial, and a system of comparing results between participating centres was developed to achieve consistency. The use of volunteer peer mentors and paid professional exercise instructors in the trial has also been explored, with results showing that peer mentors found home visits more useful than telephone contact in assisting with exercise promotion.

Overall, the research highlights the importance of physical activity-based interventions in preventing falls and promoting exercise behaviour in older people and those with intellectual disabilities.